Melatonin premedication improves quality of recovery following bariatric surgery - a double blind placebo controlled prospective study.

BACKGROUND: Melatonin has hypnotic, sedative, analgesic, anti-inflammatory, and antioxidant properties, and is a widely used sleep agent.

OBJECTIVES: Our aim was to evaluate the effect of melatonin premedication on postoperative recovery in patients undergoing bariatric surgery.

SETTING: University Hospital, Israel.

METHODS: Patients undergoing bariatric surgery were randomized to receive either 5 mg melatonin (M group) or placebo (P group) once on the night before surgery and again 2 hours before surgery. Quality of recovery was assessed using the QoR-15, a 15 item questionnaire on quality of recovery after surgery and anesthesia, regarding emotional state, physical comfort, psychological support, pain, and physical independence. A maximal score of 140 suggested good recovery (1 question was omitted due to irrelevance). The patients answered the questionnaire in the preanesthesia clinic, on admission to the operating room, and on the first postoperative day.

RESULTS: A total of 44 patients completed the study. There was no statistical difference between M and P groups in the mean QoR-15 scores obtained before the surgery. Mean postoperative QoR-15 score was higher in the M group compared with the P group (118.3±12.9 versus 107.8±18.7, respectively; P<.01). Scores were also higher in the M group regarding pain (P<.05) and quality of sleep (P< .05).

CONCLUSIONS: Use of melatonin premedication improved the quality of recovery 1 day after bariatric surgery as measured by the QoR-15, specifically the quality of sleep and pain levels. Melatonin may serve as a premedication, especially when other options, like benzodiazepines are not recommended.